By Laura Wischnowsky, Community Liaison with Continuum Hospice & Palliative Care, Guest Blogger
Hospice. This is a difficult word for some people. Just the mention of the “H” word can invoke tears and fear of immediate death. Some people even whisper the word, for fear their dying loved one will hear it. How very sad that hospice has this terrifying stigma because so many people with life-limiting illnesses miss out on the benefits available to them and their family members.
My name is Laura Wischnowsky, and I have worked in nursing homes since I was in high school. From dining room attendant and receptionist to CNA to Admissions Director, eventually becoming a licensed Nursing Home Administrator. Over the years, I have had the great privilege of helping hundreds of residents and their families through the process of selecting and settling into a long-term care facility, and then collaborating with the nurses and social workers to help the residents and families navigate through difficult end-of-life decisions when the time comes.
"I genuinely believe that hospice is a gift, and it makes me sad when people pass up the additional care and comfort...because of a preconceived notion that holds no truth." --- Laura Wischnowsky
For those of us familiar with hospice, it seems to be the natural choice once someone has been given a terminal diagnosis and no longer wishes to pursue aggressive treatments or go back and forth to the hospital. But in these goals of care conversations with residents or family members, we often hear that they’re “not ready” yet. It seems to be a widespread belief that electing hospice will somehow hasten death. That the nurse will come in to administer morphine and that will be the end.
This idea couldn’t be further from the truth about what hospice is and how it works.
Several months ago, I left long-term care to pursue a career in hospice. My goal is to educate as many people as possible about the benefits and to try to reverse the stigma. I genuinely believe that hospice is a gift, and it makes me sad when people pass up the additional care and comfort they could receive because of a preconceived notion that holds no truth.
So, what is hospice, really?
In 1963, Dame Cicely Saunders first introduced to the U.S. the idea of specialized care for the dying. “At the center of hospice and palliative care is the belief that each of us has the right to die pain-free and with dignity, and that our families will receive the necessary support to allow us to do so” [National Hospice and Palliative Care Organization, 2022]. The Medicare Hospice Benefit was established in 1983 to offer Medicare beneficiaries access to high-quality end-of-life care provided by an interdisciplinary team of professionals. Today, most insurance companies include coverage for hospice care. To qualify, one must have a terminal illness with a prognosis of six months or less (assuming the illness runs its natural course) and not be receiving any aggressive treatments intended to prolong life.
The hospice interdisciplinary team includes physicians, nurses, home health aides, social workers, spiritual care coordinators, and volunteers, all of whom provide compassionate and expert medical care, pain management, and emotional and spiritual support tailored to each patient’s needs and wishes. At Continuum Hospice, what makes us unique is that we also have Board Certified Music Therapists who visit each patient to offer the gift of live music, as well as a Certified Equine Facilitated Learning Specialist to assist families throughout the bereavement process by introducing them to the healing power of horses.
Hospice is an approach to care, so it can be provided wherever the patient calls home, including a house, apartment, assisted living community, or nursing home. For those living in a long-term care facility, the care provided by the hospice team is in addition to what is already provided by the assisted living and nursing home staff, it doesn’t replace them. Beyond the added support of the interdisciplinary team, hospice also provides and pays for all medications associated with the terminal illness for symptom control and pain relief as well as all needed medical equipment, such as oxygen, a hospital bed, specialty mattress, wheelchair, and more.
Hospice is about helping patients live each day to the fullest extent possible. Although you must have a terminal diagnosis to qualify, it doesn’t necessarily mean that you are going to die right away when you choose hospice care. Electing the hospice benefit does not mean that you have to give up hope, it just means that you want to focus on comfort and quality of life. The earlier in your diagnosis that you receive hospice care, the more opportunity there is to stabilize your symptoms and address other needs. And although the goal of hospice is to manage your care wherever you live, the patient always has the choice of going to the hospital. Some choose to revoke [hospice services] to pursue a newly available treatment option. Some people even thrive on hospice with the additional services and support they receive.
One family that I met with recently posed the question, “Knowing that hospice is fully covered by insurance and provides the patient and family with extra support, why would anyone not want it?” The only answer I could come up with was that they might not fully understand or know enough about it. Or perhaps they are afraid to accept hospice because they feel making that decision means they’ve given up hope. But we never give up on our patients - we are there for them to the very end and even beyond for their families.
The National Hospice and Palliative Care Organization is a great resource for more information on hospice care. Their website is www.nhpco.org
Continuum Hospice & Palliative Care services the entire state of Rhode Island. For more information, please visit our website at www.continuumhospice.com or give us a call at (401) 321-8101.